Impact of COVID-19 pandemic on ophthalmic presentations to an Australian outer metropolitan and rural emergency department: a retrospective comparative study

King Fai Calvin Leung,Richard Cracknell,Peter Macken,Simon Rodda,Mojtaba Golzan,Chaminda Egodage,Shweta Kaushik

doi:10.1186/s12886-022-02271-8

King Fai Calvin Leung, Richard Cracknell + Show 5 more

Open Access

https://doi.org/10.1186/s12886-022-02271-8

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Abstract

BackgroundTo analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia.MethodsA retrospective comparative study of ophthalmic emergency presentations to Campbelltown Hospital (fifth busiest NSW metropolitan ED; population 310,000) and Bowral and District Hospital (rural ED; population 48,000) before and during COVID-19 was conducted. Patient demographics, triage category, referral source, diagnosis, length of stay, departure status, and follow-up location were assessed from coding data between March 1st to May 31st in 2019 and 2020, corresponding to the peak case numbers and restrictions during the first wave of the COVID-19 pandemic in NSW. Differences before and during COVID-19 were analysed using chi-squared tests or independent sample t-tests.ResultsThere was no change in ophthalmic presentations at Campbelltown (n = 228 in 2019 vs. n = 232 in 2020; + 1.75%, p = 0.12) and an increase at Bowral (n = 100 in 2019 vs. n = 111 in 2020; + 11%, p < 0.01) during COVID-19. Urgent ophthalmic presentations (Triage Category 3) decreased at Bowral (p = 0.0075), while non-urgent ophthalmic presentations (Triage Category 5) increased at both hospitals (Campbelltown p < 0.05, Bowral p < 0.01).ConclusionsThere was no change in the total number of ophthalmic presentations to an outer metropolitan and an increase to a rural ED during the first wave of the COVID-19 pandemic in New South Wales, Australia. A change in the type of ophthalmic presentations at these peripheral EDs suggest that a high demand for ophthalmic services remained despite the pandemic and its associated gathering and movement restrictions. A flexible healthcare delivery strategy, such as tele-ophthalmology, may optimise patient care during and after COVID-19.

Highlights

To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia
Our study focused on two EDs, Campbelltown Hospital and Bowral and District Hospital, located within South Western Sydney Local Health District (SWSLHD)
There were no significant changes in the discharge diagnoses of ophthalmic presentations to Bowral and District Hospital ED. In this retrospective study, we investigated the impact of the COVID-19 pandemic on ophthalmic presentations to the ED of a busy outer metropolitan and a rural hospital during the peak of the first wave of infections in NSW

Summary

Introduction

To analyse ophthalmic presentations to an outer metropolitan and a rural emergency department (ED) during the first wave of the COVID-19 pandemic in New South Wales (NSW), Australia. The fear of contagion and social gathering restrictions in response to SARS-CoV-2 may have caused patients to avoid seeking medical attention or may have limited their access to care for non-COVID-19 illnesses [7, 12]. A similar trend has been observed for eye-care with various studies reporting a reduction in ophthalmicrelated presentations to EDs [13,14,15,16,17,18,19,20]. The first case was recorded in Melbourne, Australia on 25th January 2020, with three other cases identified on the same day in Sydney, New South Wales (NSW) [22, 23]. There was a rise in COVID-19 cases in the first wave of the pandemic in NSW during March

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